Individual
DR. KYLE DOUGLAS NIEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
221 S RIVER ST, HAILEY, ID 83333-8436
(208) 788-0061
Mailing address
100 HOSPITAL DR., KETCHUM, ID 83340
(208) 727-8800
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
732754
ID
Other
Enumeration date
01/14/2019
Last updated
01/14/2019
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